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Ileocaecal atresia.

S H Ein, S Venugopal, K Mancer

    Journal of Pediatric Surgery
    |October 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Meconium ileus can mimic other neonatal conditions. A key indicator for immediate surgery, rather than conservative treatment, is the inability of a Gastrografin enema to reflux into the terminal ileum.

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    Area of Science:

    • Neonatal Surgery
    • Pediatric Gastroenterology
    • Medical Imaging

    Background:

    • Meconium ileus is a frequent cause of distal small bowel obstruction in newborns.
    • Early diagnosis and appropriate management are crucial for neonatal outcomes.

    Observation:

    • Two neonates presented with symptoms suggestive of meconium ileus.
    • Abdominal X-rays revealed distal small bowel obstruction with a ground-glass opacity.
    • Gastrografin enema showed a microcolon without reflux into the terminal ileum.

    Findings:

    • Laparotomy identified ileocaecal valve atresia with dilated terminal ileum loops containing normal meconium.
    • Ileocolic resection was performed successfully in both cases.
    • Pathology suggested in utero intussusception as a potential cause.

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    Implications:

    • Failure of retrograde contrast reflux during Gastrografin enema necessitates prompt surgical intervention.
    • Radiological diagnosis of meconium ileus can sometimes be inaccurate, requiring clinical correlation.
    • Ileocaecal valve atresia is a treatable cause of neonatal bowel obstruction presenting similarly to meconium ileus.